Chiavacci, Eugene J
Chiavacci, Eugene J is an individual health care provider with primary practice located at 730 S Main St , Old Forge PA 18518-1459. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Chiavacci, Eugene J can be contacted via phone (570) 457-3300.Contact Information
Primary practice address
730 S Main St
Old Forge PA 18518-1459
Phone: (570) 457-3300
Fax: (570) 457-4878
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | MD027185E | Pennsylvania |
Profile Details
| NPI number | 1992794630 |
|---|---|
| LBN Legal business name | Chiavacci, Eugene J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 16th, 2005 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992794630 | NPPES |
| Pennsylvania | MEDICAID | 00920915 |
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